The last decade has seen the introduction of several new revolutionizing technologies to the surgical world. One of these is the use of small lenses and cameras to access areas of the body previously only accessible with long surgical incisions. We all have heard of gallbladders being removed with minimal scars. This technique is now being applied to plastic surgery. Facelifts, Forehead/Brow Lifts, Breast Augmentations, and Abdominoplasties are several of the procedures in which surgeons are using this technology to minimize scarring and postoperative recovery. With the endoscopic approach, the incisions are smaller, the risk of sensory nerve damage is decreased, and bleeding, bruising, and swelling may be significantly reduced.

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Endoscopic surgery utilizes a long or short fiberoptic lens, which is 1/8 inch to 1/2 inch in diameter and 6 inches to approximately 12 inches in length. The size selected depends on the procedure being performed. One end of the lens is inserted through a small half-inch incision to access a specific area of the body to allow the operation to be performed. The other end is attached to a camera, which is wired to a television, which allows visualization of the area of surgery. Separate half-inch incisions are then made to allow access for the laser scalpel, dissectors, and retractors. The operation is then performed while watching the television and manipulating the various instruments externally; not unlike playing a complex video game. The results have been excellent in the proper individuals with minimal scarring and shorter postoperative recovery.

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The incision selected depends on the operation being performed. The long temporal incision, which extends down in front of the ear and around the back of the ear for a traditional Facelift, can be replaced by a half-inch incision in the scalp, one behind the ear and a third under the chin to allow access to the neck. Thus, there are no visible incisions, and complications are minimized.

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The traditional long ear-to-ear incision for a Forehead/Brow Lift, is replaced with three half-inch incisions along the scalp. Previous loss of sensation and hair is eliminated. Since forehead/brow lift procedures are very often necessary to obtain the best result from upper eyelid surgery, this is a far superior option than the traditional procedure. The frown lines between the eyes can be significantly reduced, producing a happier, brighter, more youthful face.

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The endoscopic technique has allowed better visualization of the dissection when placing a breast implant through an axillary incision for breast enlargement. Complications are minimized since the entire dissection can be visualized, compared to traditional techniques. Also, breast asymmetries and implant migration may be minimized. Endoscopic surgery may also allow correction of a capsular contracture ( scar tissue which forms around an implant ) or evaluation of an existing implant.

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Traditional Abdominoplasties are performed through long incisions in the bikini line. This incision can widen in time or can flaw and otherwise excellent result. In selected individuals a significantly smaller incision can be used, and the endoscopic technique can be used to tighten the abdominal muscles and sculpture the waistline.

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In conclusion, when this new technology is applied in the right individual, significant improvements in one's appearance can be had with significantly smaller scars in camouflaged places, with fewer complications, and with a shorter postoperative course.